Thesis on "Political Context of Health Policy"

Thesis 10 pages (2923 words) Sources: 6 Style: APA

[EXCERPT] . . . .

Health Policy

The issue of healthcare policy has garnered a great deal of interest over the past decade. In recent months the debate over the development and implementation of a healthcare policy that will serve the purpose of assisting the masses. The purpose of this discussion is to define the relationship between the political, economic and social forces that affect health policy. The research will attempt to conceptualize this relationship. The research will also seek to define the political context of health. The research will also investigate how public health and healthcare are affected by the political context. Let us begin this discussion by defining health policy.

Defining Health Policy

Health policy can have different meanings depending on the source of the definition. Some definitions define health policy strictly in terms of the delivery of care. However, according to Navarro a National Health Policy is defined as

"the main components of a national health policy should be, including (1) the political, economic, social, and cultural determinants of health, the most important determinants of health in any country; (2) the lifestyle determinants, which have been the most visible types of public interventions; and (3) the socializing and empowering determinants, which link the first and second components of a national health policy: the individual interventions and the collective interventions (Navarro,2007).

Navarro explains that a national health policy has three determinants. These determinants work together to guarantee that the health policy that is adopted is efficient and beneficial to the whole of society. Now that we have defined health policy let us focus on determining the relationship between the political, economic and social forces that affect health policy.

Relationship between the political, economic and social forces that affect health policy

The issues of politics, economics and social forces all have a relationship to the manner in which health policy is addressed in society. This relationship exist because all of the aforementioned spheres have stakeholders who are affected in some way by the type of health policy that this adopted (Banerji 2006) . As such all of these factions have a say in the type of health of policy that is adopted.

As it pertains to the realm of politics, different political factions are stakeholders in the development and implementation of health policy. As it pertains to the development of health policy, the position that many politicians hold is based on their constituency they serve and their party allegiances. Politicians are only in office because people vote for them to be there or because they are appointed based on their position within a particular party. When a politician is beholden to their constituency the decisions they make concerning health policy legislation is often reflective of the needs of their constituency. If the constituency desires to have a health policy that is affordable and offers certain standard benefits, the type of health policy that the politician sponsors or encourages will be reflective of the needs of their constituency. Additionally, politicians are also influenced by party affiliation. If a party's platform involves a health policy that is universal, the politician associated with that party will quite often support the type of health policy that their party supports.

In either case the politician is often beholden to their constituency or to their party or to both depending on the type of political structure that governs the country. If politicians fail to encourage health policies that are consistent with the needs and desires of the constituency or the party they are affiliated with they may not be reelected,

As a result of this dependency politicians are stakeholders as it pertains to the development and implementation of health policy.

In addition to the aforementioned relationship between health policy and politics, there are other issues that make health policy political. According to a report entitled "Towards a New Politics of Health" there are five factors that make health policy political. These five factors include: unequal distribution, health determinants, organization, citizenship and globalization. These factors are explained as follows

Unequal distribution- Some groups within society also have more access to healthcare and other services than others. As such many health policies are governed or propelled by the unequal distribution of healthcare and other services related to health (Bambra et al., 2003).

Health Determinants- social determinants such as income and income can be altered by political interventions. As a result these determinants depend on political action.

Organization: any concerted effort designed to meet the health needs of the populace is determined by 'the organized efforts of society' (Secretary of State for Social Services, 1988) or the engagement of 'the social machinery' (Winslow, 1920; Bambra et al., 2003)."

Citizenship: access to 'a standard of living adequate for health and well-being' (UN, 1948) is, or should be, an aspect of citizenship and of human rights (Bambra et al., 2003)." That is every human being should have access to healthcare simply because they are human. This solidifies the idea that healthcare is a human right and not a privilege for the rich few (Bambra et al., 2003).

Globalization: the increased rate at which the world is connected via technology and transportation has created a complex global crises that is social, economic, ecological and ethical (Bambra et al., 2003). The authors explain that this crises will likely lead to bad health and premature deaths (Bambra et al., 2003).

The author explains that ultimately health policy is

"political because power is exercised over it. The health of a population is

not entirely under the control of an individual citizen, nor of a doctor

(especially not of a doctor, except in some instances of individual disease), but is substantially under the control of the social relations of the capitalist system. Changing this system and these relations are only achievable through politics and political struggle (Bambra et al., 2003).."

Indeed health policy is political because political action or inaction impacts the manner in which health policies develop and are implemented. Political forces can change the nature of the healthcare that is delivered.

In addition to the political nature of health policy, it is also economic. Healthcare can be extremely expensive. In addition healthcare is an economic sector unto itself. It is inclusive of doctors nurses, pharmaceutical companies and other sectors involved with providing healthcare. Because all of the aforementioned people and industries are effected by the health policy, the economy is also a stakeholder in the type of health policy that is developed.

Economics also has a relationship to health policy because of poverty and the unequal access to care that poor people have. Regardless of the country poor people usually have the most limited access to care. According to an article published by the World Bank entitled " cost recovery is a major economic issue as it pertains to helath policy. The article explains

"On the face of it, the issue of cost recovery is, from an ethical perspective, an open-and-shut case. User fees deter patients, especially poor ones. And where they do not, they end up absorbing a larger share of the income of a poor household than of a rich household (ie they are regressive)."If the aims are to improve the health of the poor and to prevent households from becoming impoverished through ill health, then clearly user fees are to be avoided (Wagstaff 2001)."

Although the idea of not having user fees may seem to ideal, particularly for the poor, is not a feasible solution. The authors explain that this is not a feasible solution because there are real costs associated with the delivery of health services. These costs are not just monetary. The authors further explain that free healthcare services often lead to extended periods in which to receive care. These waits can lead to a loss in income. In addition there are transport costs associated with the delivery of healthcare. With these costs understood, in theory user fees should reduce the waiting periods associated with free care. In addition such fees allow health care services to expand and increases the amount of overall healthcare available. This would mean that the cost associated with receiving healthcare would be reduced for the poor.

The author further explains that the quality of free healthcare services can also deter people from seeking free care, even poor people. The article asserts the poor often choose to forego free healthcare because of the quality of the service. For instance, in some cases, free clinics may not have access to the medicines that people need. As a result even those that have low incomes choose not to go to free clinics. Instead they will pay or travel to go to clinics that are not free. The authors further explain that "If user fees were introduced and the revenues could be used to improve quality, there might well be an improvement in the health of the poor with only a modest increase -- if any -- in the overall costs associated with ill health. It may well also be the case… READ MORE

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